Provider Demographics
NPI:1124198395
Name:CENTER FOR SPINAL SURGERY PREVENTION
Entity Type:Organization
Organization Name:CENTER FOR SPINAL SURGERY PREVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:B
Authorized Official - Last Name:MINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-392-5851
Mailing Address - Street 1:5036 NEW CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1614
Mailing Address - Country:US
Mailing Address - Phone:910-392-5851
Mailing Address - Fax:910-392-6012
Practice Address - Street 1:5036 NEW CENTRE DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1614
Practice Address - Country:US
Practice Address - Phone:910-392-5851
Practice Address - Fax:910-392-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2458674Medicare UPIN